Effect of the Early Introduction of Trophic Donor Human Breast Milk on the Preservation of Postoperative Gut Functions in a Fasting Animal Model

Abstract

Dietary restrictions, such as avoiding oral intake until postoperative ileus resolves, can result in negative nitrogen balance, weakened immune function, and impaired digestive system performance. This study investigates the efficacy of donor human breast milk (HM) in early trophic enteral feeding and its impact on gut functions during prolonged postoperative fasting in an animal model. Male Wistar rats were deprived of food for 48 hours with free water access. After a complete ileal transection and an end-to-end intestinal anastomosis, the rats were divided into three groups: prolonged fasting (PF), early trophic feeding with HM, and feeding with commercial formula (CF). Each group was further divided into 48- and 72-h postoperative subgroups. The study measured the number of colony-forming units in mesenteric lymph nodes, serum alkaline phosphatase (ALP) levels, and histopathological data between groups. At postoperative 48 and 72 hours, the mean apoptotic index of HM group was significantly lower than in PF group (P<.001). A significant decrease was observed in apoptosis in HM group over time (P=.047), while the CF (P=.327) and PF (P=.959) groups did not show significant changes. HM significantly prevented villus atrophy (P<.01), and bacterial translocation to mesenteric lymph nodes (P<.05) compared to CF and PF. Serum ALP levels, an indicator of intestinal mucosal regeneration, was significantly highest in the HM group at 72 hours compared to other groups (P=.03). These findings suggest that HM not only maintains the structural and functional gut integrity but also promotes earlier and more effective recovery of the intestinal health. © 2025 Elsevier Inc.